since September of last year I've had 15 or 16 UTIs - I'm beginning to lose count. I currently have yet another UTI with all the usual symptoms. Went to the doctor on Monday and provided a urine sample. The test results were back today (Thursday 16 Nov) and I'm told that I don't have a UTI?

I've been prescribed Trimethprim (for the UTI that apparently I don't even have) and my doctor has told me to finish the course of antibiotics.

What is going wrong here with the way that the NHS are culturing the urine? and what can I say to my doctor?

Where to start with this. Put simply the global standard for urine analysis is 60 years out of date and the protocols laid down were never designed for UTI but for kidney infection. The focus is on a fast growing pure growth bacterium that is culturable in the laboratory within 18 hours dismissing any other bacteria grown as contaminants or mixed growth. The markers of infection are set too high and this applies to not only urine analysis but also dipsticks. One recent study noted that they only picked up 51% of infections missing therefore 49%. It is now well known that infections are polymicrobial and of different growth rates.

There is growing concern in the medical profession about the issue of culture for urine samples given that UTI is the second most common cause of sepsis but despite the research evidence there about the failure of testing as yet no new revised guidelines have been set by NICE.

There is a private company who will do a longer medical culture if markers of infection are found in your urine on initial culture. So that is ether leukocytes, blood, protein, nitrates or even bacteria and they will then culture the urine for a longer period of time to determine what bacteria have grown and their antibiotic susceptabilities and resistances. BHUK can give you details if you call the office. You liaise directly with them and will receive the results yourself which you can then take to your GP. A number of forum members have used this service.

One of the big problems in treating UTIs is the short course low dose fixation on antibiotics. Nearly 80% of E. coli cultures are now resistant to Trimethoprim because whilst some of the bacteria may have been killed many have adapated and overcome the antibiotic treatment so that they can evade antimicrobial therapy.

I assume you have tried naturals as well such as D Mannose? This is very effective against ecoli infections and a good preventative. This company has an excellent website and very very helpful helpline if you want to give them a call.

Obviously you must look at lifestyle as well. Is anything precipitating the flare up in symptoms? GIve bacteria an inch and they will take a mile. They thrive on sugar and stress so it may be worth going low sugar for a while. Try a bland diet to calm any inflammation. If female, post menopausal women are very prone to infections due to the lack of oestrogen thinning tissue and leaving the urethra open to bacterial invasion.

If infections are continuous then your GP should refer you to a urologist for further testing to check for strictures, stones, possible bladder cancer or anatomical issues. A scan or ultrasound can be organised but I’m afraid the actual urine test he/she may do will be exactly the same one as your GP has ordered so don’t expect any joy there.

Finally there are specialists in the UK who are specifically focusing on recurrent and often chronic infections. BHUK can send you an information pack with more details if you give them a call. An excellent book to get hold of is that written by Angela Kilmartin with lots of hints and tips to avoid getting further infections and how to manage infections when symptoms do arise.

There is a private company who will do a longer medical culture if markers of infection are found in your urine on initial culture. So that is ether leukocytes, blood, protein, nitrates or even bacteria and they will then culture the urine for a longer period of time to determine what bacteria have grown and their antibiotic susceptabilities and resistances. BHUK can give you details if you call the office. You liaise directly with them and will receive the results yourself which you can then take to your GP. A number of forum members have used this service.

I’ll be ringing the office later this morning thanks.

I assume you have tried naturals as well such as D Mannose? This is very effective against ecoli infections and a good preventative. This company has an excellent website and very very helpful helpline if you want to give them a call.

I have indeed (and still do) try naturals. I have a large tub of D Mannose along with liquid Potassium Iodide (courtesy of Dr. Jonathan Wright http://tahomaclinic.com/2011/01/iodide/) and I drink high quality Colloidal Silver. This protocol keeps the infection at bay for two weeks at most.

Obviously you must look at lifestyle as well. Is anything precipitating the flare up in symptoms? GIve bacteria an inch and they will take a mile. They thrive on sugar and stress so it may be worth going low sugar for a while. Try a bland diet to calm any inflammation. If female, post menopausal women are very prone to infections due to the lack of oestrogen thinning tissue and leaving the urethra open to bacterial invasion.

I exercise regularly (High Intensity Interval Training with Strength Training). Ifollow a Paleo diet (about 90% to 95% of the time) so sugar and grain products are rare on my plate. Also, I do not eat dairy (with the exception of home made kefir made from raw milk – good for gut bacteria).

I don’t really have a lot of stress as I’m self employed and doing OK on that front. I'm only stressed because of repeat infections.

I’m male so presumably I don’t have any oestrogen issues.

If infections are continuous then your GP should refer you to a urologist for further testing to check for strictures, stones, possible bladder cancer or anatomical issues.

With regards to this – I have a follow up urology appointment at our local Blackpool hospital on 28th Nov so I’ll speak to them and mention my concerns and your suggestions about further tests etc… Also, having checked the resources I've asked my GP to refer me to see Mr A in Wakefield. From what I could gather he would be the best person for me to see. He's got qualifications that cover every symptom I've had plus apparently he's an expert of Bio Films. I might be wrong but I suspect I may have a Bio Film - it seems to fit that e coli pops out once a month.

Finally there are specialists in the UK who are specifically focusing on recurrent and often chronic infections. BHUK can send you an information pack with more details if you give them a call. An excellent book to get hold of is that written by Angela Kilmartin with lots of hints and tips to avoid getting further infections and how to manage infections when symptoms do arise.

I’ll be calling the office later as mentioned earlier because I’d very much like to speak/see someone to end this monthly hell.

I had a quick look on Amazon for the book written by Angela Kilmartin but she’s written several – is there a particular book that you had in mind?

I’ve had to edit your post I’m afraid as we cannot mention specialists on here but I’m aware of whom you mean and yes he has an keen interest in biofilms having spent time working with one of the few biofilm specialists treating patients in the UK (sadly not currently taking new patients).

Thanks for the heads up for which book - it's unavailable at the moment (apart from getting it shipped from the US at a rip off price). I'll wait until it comes back into stock.

I'll be going to the doctors on Monday to ask him, why if I've got the exact same symptoms that I've had 15 to 16 times since last September, a UTI, and the local hospital say I don't have an infection - then what is it that I've got. As I write this - my urethra hurts like hell.

Coincidentally I've got an appointment letter through from our local hospital for a follow up appointment with the urologist - that should be interesting.

Thank you again Susan for your kind help. I tried ringing the helpline on Friday but couldn't get through so I've sent them an explanatory email with your points listed above.

Finally there are specialists in the UK who are specifically focusing on recurrent and often chronic infections. BHUK can send you an information pack with more details if you give them a call. An excellent book to get hold of is that written by Angela Kilmartin with lots of hints and tips to avoid getting further infections and how to manage infections when symptoms do arise.

Hi,

Could you please send me an information pack with who to call?

i was with Prof at the Hallamshire in Sheffield but he's now signed me off as he's tried everything.

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